Abstract
While rare, cutaneous SCC in patients with darker Fitzpatrick skin types is essential to identify and investigate early and can have a myriad of clinical presentations. While clinical history-taking of suspicious skin lesions is often symptom-driven, other key patient history components, such as surgical history, are often overlooked. Differentiating, prioritizing, and risk-stratifying hyperkeratotic, verrucous papules in patients with darker Fitzpatrick skin types is an essential clinical skill for clinicians to develop to serve an increasingly diverse patient population. This original report presents the case of a displaced orthopedic screw causing pseudoepitheliomatous hyperplasia that was initially misdiagnosed as squamous cell carcinoma. This case highlights the importance of careful consideration of surgical history, choice of biopsy method, and skin type when examining lesions concerning for squamous cell carcinoma.